新冠肺炎病例的臨床特徵仍不清楚,根據2月24日Lancet Infectious disease臨床期刊報導,81位於2019年12月20日到2020年1月23日期間確診之就醫個案當中,52%為男性、平均年齡為49.5歲, 新冠肺炎病例的肺部CT影像呈現嚴重程度不同的肺毛玻璃狀病灶,即使為無症狀的病例,也會迅速在1-3周內發展成瀰漫性肺毛玻璃狀病灶。因此,肺部CT 影像合併臨床與實驗室結果,將可加快早期新冠肺炎的診斷。

(財團法人國家衛生研究院 蔡慧如博士摘要整理)

Background
A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.
Methods
Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.
Findings
81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).

Author:Heshui Shi, Xiaoyu Han, Nanchuan Jiang, et al.
原文連結:https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30086-4/fulltext

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